The sirolimus-eluting cypher select coronary stent for the treatment of bare-metal and drug-eluting stent restenosis: Insights from the e-select 64-71 (multicenter post-market surveillance) registry

Alexandre Abizaid, J. Ribamar Costa, Adrian Banning, Antonio L. Bartorelli, Vladimir Dzavik, Stephen Ellis, Runlin Gao, David R. Holmes, Muyng Ho Jeong, Victor Legrand, Franz Josef Neumann, Maria Nyakern, Amy Orlick, Christian Spaulding, Stephen Worthley, Philip M. Urban

Research output: Contribution to journalArticle

Abstract

This study sought to compare the 1-year safety and efficacy of Cypher Select or Cypher Select Plus (Cordis Corporation, Bridgewater, New Jersey) sirolimus-eluting stents (SES) with the treatment of bare-metal stents (BMS) and drug-eluting stent (DES) in-stent restenosis (ISR) in nonselected, real-world patients. There is paucity of consistent data on DES for the treatment of ISR, especially, DES ISR. The e-SELECT (Multicenter Post-Market Surveillance) registry is a Web-based, multicenter and international registry encompassing virtually all subsets of patients and lesions treated with at least 1 SES during the period from 2006 to 2008. We enrolled in this pre-specified subanalysis all patients with at least 1 clinically relevant BMS or DES ISR treated with SES. Primary endpoint was major adverse cardiac events and stent thrombosis rate at 1 year. Of 15,147 patients enrolled, 1,590 (10.5%) presented at least 1 ISR (BMS group, n = 1,235, DES group, n = 355). Patients with DES ISR had higher incidence of diabetes (39.4% vs. 26.9%, p <0.001), renal insufficiency (5.8% vs. 2.3%, p = 0.003), and prior coronary artery bypass graft (20.5% vs. 11.8%, p <0.001). At 1 year, death (1.4% for BMS vs. 2.1% for DES, p = 0.3) and myocardial infarction (2.4% for BMS and 3.3% for DES, p = 0.3) rates were similar, whereas ischemia-driven target lesion revascularization and definite/probable late stent thrombosis were higher in patients with DES ISR (6.9% vs. 3.1%, p = 0.003, and 1.8% vs. 0.5%, p = 0.04, respectively). Use of SES for either BMS or DES ISR treatment is safe and associated with low target lesion revascularization recurrence and no apparent safety concern.

Original languageEnglish
Pages (from-to)64-71
Number of pages8
JournalJACC: Cardiovascular Interventions
Volume5
Issue number1
DOIs
Publication statusPublished - Jan 2012

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Keywords

  • in-stent restenosis
  • sirolimus-eluting stent(s)
  • target lesion revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Abizaid, A., Costa, J. R., Banning, A., Bartorelli, A. L., Dzavik, V., Ellis, S., Gao, R., Holmes, D. R., Jeong, M. H., Legrand, V., Neumann, F. J., Nyakern, M., Orlick, A., Spaulding, C., Worthley, S., & Urban, P. M. (2012). The sirolimus-eluting cypher select coronary stent for the treatment of bare-metal and drug-eluting stent restenosis: Insights from the e-select 64-71 (multicenter post-market surveillance) registry. JACC: Cardiovascular Interventions, 5(1), 64-71. https://doi.org/10.1016/j.jcin.2011.09.016